title: Course of recovery and prediction of outcome in young patients in a prolonged vegetative or minimally conscious state after severe brain injury: An exploratory study.
abstract: OBJECTIVE
  To explore the course of recovery of consciousness and factors predicting the outcome of severe brain injury with a prolonged period of unconsciousness in children and young adults receiving a specialized rehabilitation treatment, the Early Intensive Neurorehabilitation Programme (EINP).
  
  
  METHODS
  A cohort of forty-four patients aged 1.6-25.5 years (M=16.0) with traumatic acquired brain injury (TBI) or non-traumatic acquired brain injury (nTBI) were examined using the Western Neuro Sensory Stimulation Profile every two weeks, from the application for EINP until discharge. The level of consciousness was assessed with the Post-Acute Level of Consciousness Scale, and the level of disability was determined by the Disability Rating Scale. Long-term level of disability of all TBI patients (N=32) was assessed between 2.0 and 4.4 years after discharge from EINP.
  
  
  RESULTS
  Two-thirds of all patients recovered to consciousness. Three recovery patterns were identified: remaining in a vegetative state (VS), slow recovery of consciousness, and fast recovery of consciousness. In the long-term, 11 of the TBI patients were severely disabled, 13 were moderately disabled, and 4 were mildly disabled. All TBI patients who were in VS at discharge either had deceased, or recovered to a very severely disabled state.
  
  
  CONCLUSIONS
  Three recovery patterns identified in an early stage after starting EINP made it possible to predict long-term level of disability.
authors.affiliation: Project VLB-NAH, Tilburg, Division Research, Rehabilitation Centre Leijpark, The Netherlands. h.j.eilander@brain-consult.nl
authors.forename: Henk J
authors.initials: HJ
authors.lastname: Eilander
authors.forename: Caroline M
authors.initials: CM
authors.lastname: van Heugten
authors.forename: Viona J M
authors.initials: VJ
authors.lastname: Wijnen
authors.forename: Marcel A
authors.initials: MA
authors.lastname: Croon
authors.forename: Paul L M
authors.initials: PL
authors.lastname: de Kort
authors.forename: D Andries
authors.initials: DA
authors.lastname: Bosch
authors.forename: Arie J H
authors.initials: AJ
authors.lastname: Prevo
mesh_terms: D000293:Adolescent; D000328:Adult; D001930:Brain Injuries / Q000150:complications / Q000534:rehabilitation*; D002648:Child; D002675:Child, Preschool; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation; D005260:Female; D006801:Humans; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D018458:Persistent Vegetative State / Q000209:etiology / Q000534:rehabilitation*; D011379:Prognosis; D020127:Recovery of Function; D012720:Severity of Illness Index; D055815:Young Adult